Monday, 28 April 2014

Finally, March is over, and so are my 30's

I know I’d said 500 words a week, and when I said it, I meant it; but that was before March turned into a nightmare of 14-hour days, including 2 weeks away from home at just the worst time of the year.  “What about April?” I hear you say; well it’s taken me this long to recover from March to be honest.  I’ve had several thoughts about things to write about but somehow something has always cropped up in its place, and given the choice of writing about stuff I’ve done, or actually doing that stuff, you’ll find me out there getting on with it.

 As well as work always being busy in March with the close out of the EUETS verification season, and this year compounded by operators being absolutely clueless about the new regulations; it’s also a bit of a turning point in the year in other ways as well. 

March is when the action really starts to kick off in the garden, with the days getting longer, the grass growing more quickly, the weeds springing up and things needing planting, pruning  and tidying.   Looing out of my bedroom window as I type, I can see the fig tree and grape vine that needed pruning, the raspberry bed that needed replanting, along with the addition of honeyberries for the first time (looking forward to those), and a catch crop in amongst those of good king henry and some French beans to climb the poles of the raspberry cage. 

Around the corner is the main vegetable bed and greenhouse with, so far 2 types of carrots, parsnips, kohl rabi, cima di rapa (an Italian broccoli), beetroot, lettuce, broad beans, sea kale in the ground, plus the fruit bushes of gooseberry, blackcurrant and rhubarb which is already cropping well in mid April.   In the greenhouse are the seedlings of courgette, cucumber, tomato, chilli, spinach and the ongoing flower and tree seedlings.  Around the corner again are the Jerusalem artichoke bed, wild garlic and the established apples and pears.  I’ve also added four more this year, so I now officially have an orchard (anything more than 6 fruit trees).

The bonsai have also been busy this year, both in propagation of cuttings and seedlings but also the ongoing annual maintenance pruning, wiring and re-potting.  I’ve also bought 4 new trees at knock down prices from a local nursery sale; a larch which I’ve always wanted, an oak, a hornbeam and a vitis vinifera.  So all in all, I’ve been quite busy in the garden.

In amongst that I’ve been trying to keep up with the training plan I’d set for myself, building currently to The Yomp on Sunday 1st June.  I’ve now started to include a weekly speed session of either a tempo session of 6-8km at half marathon pace, or a nasty little session of 1km warm up, followed by 2km at 20s/km faster than HM pace, alternating with 1km active recovery. These sessions are not intended to contribute necessarily to speed on the longer races, but should help in the latter stages as my legs tire, just to give that extra bit of oomph.  The real use for the speed work will come in September in the HM.  Through that I’ve also been increasing steadily the long run, up to 30km tomorrow, with a three week progression and then one week off.

Throughout that, of course, and just everyday, I’ve been carrying on trying to manage the Type 1 diabetes and blood sugar control associated with it.  With the stress of March my BG became a little more erratic and I started experiencing frequent highs and a general upwards drift from my usual levels of 5-6.5 during the day to start seeing 8’s, 9’s and 10’s.  So what did I do about it? Two things; 1) get my priorities right, health before work, make sure I got my exercise in to keep that insulin sensitivity where it should be and also act as a stress buster, 2) I upped my basal rate by 10% for about a week, the combination of those did the trick and I was soon back where I needed to be again.

April had the opposite challenge with a trip to Tunisia for work, where I was fully expecting a raft of hypos to come along due to the heat having an effect on insulin absorption etc.  To prepare for that, I consulted the DSN I work with and decided to try a 10% basal reduction and possible bolus reduction as well.  IN the event, it wasn’t actually that hot, not more than mid 20-s Celsius and I abandoned the basal adjustment as I started drifting high.

The one thing I still haven’t gotten away from though is the frequent exercise induced hypos. At their extreme as an example, on a long run day I reduced basal and bolus to 1 unit each, and at the start of my run set out at 13.9 mmol/l.  5km later at my first test, I was at 3.8 mmol/l, a massive drop with hardly any IOB.   Even on shorter runs I need to be quite careful with anything aerobic giving the risk of big drops like last Thursday going from 7.0 to 4.6, and even with a snack dropping to 3.6 at the end of the run. 

The only things so far that don’t cause massive drops like that are yoga, fasted morning runs where I’ve not yet eaten or injected basal and the speed sessions where the adrenaline kicks in.  With all of those I tend to stay pretty level or have a slight rise.

Put all of those issues together, plus my need to eat to avoid hypos during exercise, which kind of goes against the whole point of exercise, I’ve been approved for a pump – Big hooray, much excitement.  All in all that's probably the best birthday present I could have had (unless you happen to have a spare working pancreas handy?).  Now I need to choose which one, in about two weeks and then I should be pumping by September, just after my HM and just before a trip to Algeria, what fun.

So far with my research I’m probably leaning towards the new CellNovo or Roche Insight, but I’ll get my hands on them in May at my pump choice clinic.

I’ve also had another birthday in the last few weeks, the big 40, but I’ve kept it low key.  The main celebration was my family coming over for a weekend which included a decent amount of over eating, over drinking and a nice day out mountain biking and picnicking at a local forest park followed by a decent meal out at a riverside pub.  Overall I’m not really one for birthdays, and in particular this year coming off the back of the March from hell I really didn’t have much enthusiasm for it and couldn’t really be arsed with telling people things to buy me, mainly because I can buy pretty much whatever I think I want/need myself anyway.  I’m planning on a few new book purchases on home brewing and insulin pump management – what a fun life I live.

Other people saw fit to buy me 40 year old bottles of Madeira and Bordeaux, which are very much appreciated, especially the dry Madeira, but these things have a tendency to end up sitting in a cupboard, as with my 40 year old single malt, mainly because I see those kind of things as too expensive to drink.

So the only bit of detailed training outcome I’m going to put in here is yesterday’s long run, planned at 30-32km, came in at 31.3km, in about 2hr 52, and more importantly no niggles during it, and the legs felt strong throughout. So with my next race of about 23 miles in 5 weeks, I’m feeling pretty good overall.  The BG control was not quite where I wanted it though, running a bit lower than I would like to have been to be honest.  It went a bit like this;

Distance, BG, carbs eaten
  • Before setting out 13.5  (large breakfast and 1U bolus)
  • 5km 4.6, 30g
  • 10km 5.1, 13g
  • 15km 4.7, 30g
  • 20km 4.6, 18g
  • 25km 4.6, 18g
  • 30km 4.2, 13g
  • 32km 4.6, 30g
  • +40min 7.8      
  • +70 min 8.2     

 
So you can see that it’s running pretty close to hypo territory throughout, but relatively steady.  Looks like I need a good 45-60g carbs an hour, but I may talk to the right DSN at Addenbrookes and see what she thinks about dropping that morning basal right back to 0.5U

More later

Friday, 7 March 2014

Come On Pancreas, Get your Act Together

I knew it was optimistic to say I was going to guarantee writing 500 words a week. The problem was never going to be the word count, just making the time to be able to write. This is one of the busiest times of the year for me (aren’t they all), but also has the added pressure of a deadline that is government imposed and has no negotiation.  The overall effect of that is that this last week I’ve been working at the weekend and then waking at 5am to get a bit of work done before breakfast followed by more work after dinner.  Luckily I’ve been away so I can do that without disturbing anyone else.  Only another 4 weeks of it to go, and then I intend taking a few easy days before it all starts again.
Last week I was lucky enough to be in a new place to run.  I had a short trip to the Shetlands, which involved a very long day of travel to get up there but with the reward of some spectacular scenery and a very nice old farmhouse just outside Brae converted into a hotel. For context, the population of the Shetlands is about 23,000, Ely (a small market town/city in the Fens) is about 20,000.  The general feel of the Islands is not one of Britain, but much more Scandinavian, with Britain referred to as the South Island and their own largest island referred to as Mainland.  Historically, the Shetlands were Scandinavian in fact as well as feel, only becoming part of Scotland in 15th century due to being pledged in dowry by a Norwegian king when his daughter married James III. 

 Looking a bit windswept at the top there.  My hotel is across the bridge and over the hill
 
The downside of being effectively perched in the North Atlantic just when a major low pressure happened to be passing was pretty obvious, not raining, but bloody windy.  The islands are lumpy, but not that tall, meaning that when it blow, there’s not a lot of shelter.  From a running point of view that makes it pretty challenging with a constant up and down on short sharp hills and turning in and out of the wind which makes it very hard to get a rhythm going.  Still I got a few good pics of the area and me.  But it was nice to run in a different place just to say I’ve been there.  I got to run in the hills around Brae and then a night run around the capital Lerwick where I easily burned off a trio of young Lerwick Rugby club lads, just cruising past at HR 148 and about 4:45/km.  Either they were very unfit, or not trying at all.
I’ve also included a few cool pics of Sumburgh airport runway, jutting out into the sea; to get there you need to take a road that goes right across the end of the runway.


Yes, that is a wave breaking over the end of the runway
I’ve now started into the long run progression leading up to my next race.  It’s three months away, but starting at 10miles/16km now, and adding 10% a week, every fourth week being  a cutback week gives me just the right progression for a 23 miler in 12 weeks and then carries on to the 40 miler in August.  Oddly enough, completely at random, I’ve also given myself my birthday off (just a short run).  The speedwork starts at the beginning of April, focussing on long intervals and tempo runs.
This isn’t about the diabetes, but it is what I’m living with.  Overall it’s still going reasonably well apart from the odd occasion where my honeymoon status or my relative inexperience make themselves felt. 
Take last weekend for example, in preparation for the long run, I cut my morning bolus back by one third (bolus left the same as I wasn’t running that close to breakfast).  Now with anyone else that would result in a very high BG level until starting the run, and that’s what’s happened to me as well.  But Sunday? No, my BG actually fell and the same thing happened all three meals on Sunday – obviously an extra spurt from the Pancreas.  And then on Monday?  Well after a normal reasonable breakfast, I was on the way up to Aberdeen, grabbing lunch at the airport, quick look on the website tells me 48g carbs for my ham and cheese baguette, OK, 3 units then, starting from 5.4 should be no problem should it?  Well at +2 hours that was 10.1, way too high.  Obviously I need to stay away from the white baguette from now on, but what to do about it?  Go for a quick run. 
This week I’ll be getting up to about 50km and it should be going up from here, there’s a big temptation to run again and again while it feels good, but you need to keep an eye on the bigger picture; experience has told me that you can’t go from 30km a week to 80-100km a week in one step unless you want injuries.